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Median Nerve Anatomy and Entrapment Syndromes 正中神经解剖与卡压综合征
Pub Date : 2024-04-25 DOI: 10.21129/nerve.2024.00549
Se-Hyuck Park
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引用次数: 0
A 3D-Printed Model for High Sacrectomy of a Marjolin’s Ulcer–Associated Sacral Tumor: A Case Report and Literature Review 马乔林溃疡相关骶骨肿瘤高位骶骨切除术的 3D 打印模型:病例报告和文献综述
Pub Date : 2024-04-25 DOI: 10.21129/nerve.2024.00542
Woong Rae Jo, Sae Min Kwon, Chang-Young Lee, C. Kim, In Soo Kim, Jaehoon Choi, Hye Ra Jung, Young San Ko
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引用次数: 0
Clinical Characteristics of Sciatica in Patients with Piriformis Syndrome Improved by Decompression Surgery 通过减压手术改善梨状肌综合征患者坐骨神经痛的临床特征
Pub Date : 2024-04-25 DOI: 10.21129/nerve.2024.00521
Dong-kwan Lee, Byung-chul Son
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引用次数: 0
Incidence and Predictors of Kummell’s Disease in Patients with Benign Vertebral Compression Fractures 良性椎体压缩性骨折患者库姆梅尔病的发病率和预测因素
Pub Date : 2024-04-24 DOI: 10.21129/nerve.2024.00556
Jeong-Ju Hong, C. Jwa, Jae Hoon Kim, H. Kang, In-Suk Bae, Hyungjoo Kwon
Objective: Kummell's disease (KD) is a form of delayed vertebral compression fracture. However, its incidence and predictors remain unclear. We investigated the incidence rate and predictors of KD in patients with benign vertebral compression fractures. Methods: We retrospectively analyzed 437 consecutive patients with benign vertebral compression fractures admitted to the neurosurgical department of Nowon Eulji Medical Center between 2015 and 2018. The inclusion criterion was patients with newly diagnosed KD at ≥20 years of age. The control subjects had acute benign vertebral compression fractures. Univariate and multivariate regression analyses were performed to evaluate the predictors of KD. Results: In total, 39 patients (8.9%) were newly diagnosed with KD, with an average age of 77.3 years. In older patients (≥70 years), the incidence was 12.8%. The incidence rate was highest in patients in their 70s. Most cases of KD (69.2%) occurred in the thoracolumbar region. Multivariate regression analysis showed that age ≥70 years (odds ratio [OR], 3.24; 95% confidence interval [CI], 1.05–9.97; p=0.041) and a history of ischemic stroke (OR, 2.92; 95% CI, 1.26–6.74; p=0.012) were independently associated with KD. Conclusion: KD appears to be relatively common, especially in older people (≥70 years). Older age and a history of ischemic stroke may be independent predictors of KD. This study also indicated that ischemic factors may play a more important role than mechanical factors in the development of KD from vertebral compression fractures
目的:库姆梅尔病(KD)是一种迟发性椎体压缩性骨折。然而,其发病率和预测因素仍不清楚。我们研究了良性椎体压缩性骨折患者中 KD 的发病率和预测因素。研究方法我们回顾性分析了2015年至2018年期间诺远乙支医疗中心神经外科连续收治的437例良性椎体压缩骨折患者。纳入标准为年龄≥20岁新诊断为KD的患者。对照组为急性良性椎体压缩性骨折。对KD的预测因素进行单变量和多变量回归分析。结果显示共有 39 名患者(8.9%)被新诊断为 KD,平均年龄为 77.3 岁。老年患者(≥70 岁)的发病率为 12.8%。70多岁的患者发病率最高。大多数 KD 病例(69.2%)发生在胸腰部。多变量回归分析显示,年龄≥70 岁(几率比[OR],3.24;95% 置信区间[CI],1.05-9.97;P=0.041)和缺血性卒中病史(OR,2.92;95% 置信区间[CI],1.26-6.74;P=0.012)与 KD 独立相关。结论KD似乎比较常见,尤其是在老年人(≥70岁)中。高龄和缺血性脑卒中病史可能是 KD 的独立预测因素。该研究还表明,在椎体压缩性骨折引发 KD 的过程中,缺血性因素可能比机械性因素起更重要的作用。
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引用次数: 0
Surgical Treatment of a Ruptured Isolated Spinal Artery Aneurysm with Negative Angiography Findings: A Case Report 血管造影检查结果为阴性的孤立脊髓动脉瘤破裂的手术治疗:病例报告
Pub Date : 2024-04-23 DOI: 10.21129/nerve.2024.00514
Jun-Woo Ha, Yangkyu Lee, K. Kim, B. Moon, Jeong-Yoon Park, D. Chin, Keun-Su Kim, Hyun Jun Jang
Isolated spinal artery aneurysms are rare vascular lesions of the spinal cord. Due to their rarity, the natural disease course and treatment guidelines have not been clearly defined. Here, we report a case of an angiography-negative isolated spinal aneurysm in the thoracic spine surgically that was treated without neurological compromise using indocyanine green (ICG) and intraoperative neurophysiological monitoring (IONM). A 52-year-old man without any prior medical history presented to the ER with acute lower back and bilateral leg pain accompanied by worsening voiding and difficulty defecating. Magnetic resonance imaging (MRI) of the lumbar spine showed a diffuse subarachnoid hemorrhage in the lumbar spine. The patient was initially treated conservatively with painkillers, but experienced a rapid recurrence of symptoms. A follow-up MRI scan showed subacute transformation and expansion of the subarachnoid hematoma, as well as a non-enhancing, intradural, extramedullary lesion at the T12/L1 level. Angiography did not show any remarkable findings, and surgical exploration revealed a thrombosed aneurysmal lesion. The lesion did not show ICG uptake, and temporary clipping of the caudal end of the lesion did not lead to changes in motor-evoked potential signals. A pathological examination revealed a capillary vascular structure in granulation tissue with organizing thrombi, favoring a thrombosed, granulated lesion over a vascular neoplasm. Rup-tured, isolated spinal aneurysms can be especially difficult to diagnose and treat when angiography findings are negative. We report that a spinal artery aneurysm can be safely excised using intraoperative ICG and IONM.
孤立性脊髓动脉瘤是一种罕见的脊髓血管病变。由于其罕见性,自然病程和治疗指南尚未明确定义。在此,我们报告了一例血管造影阴性的胸椎孤立性脊髓动脉瘤病例,该病例采用吲哚青绿(ICG)和术中神经电生理监测(IONM)进行手术治疗,未对神经系统造成损害。一名 52 岁的男性因急性下背部和双侧腿部疼痛,伴有排尿和排便困难,无任何既往病史,来到急诊室就诊。腰椎磁共振成像(MRI)显示腰椎弥漫性蛛网膜下腔出血。患者最初接受了止痛药的保守治疗,但症状很快复发。随访的核磁共振成像扫描显示,蛛网膜下腔血肿呈亚急性转化和扩大,T12/L1水平有一个无强化、硬膜内、髓外病变。血管造影未发现任何异常,手术探查发现了一个血栓形成的动脉瘤病变。病灶未显示 ICG 摄取,临时剪除病灶尾端也未导致运动诱发电位信号发生变化。病理检查显示,肉芽组织中有毛细血管结构,并伴有有组织的血栓。当血管造影结果呈阴性时,破裂的孤立性脊髓动脉瘤尤其难以诊断和治疗。我们报告了利用术中 ICG 和 IONM 可以安全地切除脊髓动脉瘤。
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引用次数: 0
Postoperative Thoracic Cord Compression Induced by a Dural Sealant System (DuraSeal®): A Case Report and Literature Review 硬脑膜密封剂系统 (DuraSeal®) 术后引起的胸脊髓压迫:病例报告和文献综述
Pub Date : 2024-04-23 DOI: 10.21129/nerve.2024.00535
Dong Soon Jang, Seung-Hun Sheen, Inbo Han, S. Lee, Woo Seok Choi, M. Bock, Seil Sohn
, hindering the improvement of the surgical site and increasing the possibility of infection. DuraSeal ® is a dural sealing adhesive that prevents CSF leakage and is used as an adjunct to enable the watertight repair of dural defects when the dura is damaged during spinal surgery. In the present case, DuraSeal ® was applied to repair a dural defect in the surgical area after thoracic spine surgery, and no neurological problems occurred immediately after surgery. However, a day later, the patient’s paraparesis worsened; therefore, reoperation was performed and the symptoms improved.
,妨碍了手术部位的改善,增加了感染的可能性。DuraSeal ®是一种硬脊膜密封粘合剂,可防止 CSF 渗漏,在脊柱手术中硬脊膜受损时可作为一种辅助工具用于硬脊膜缺损的防水修复。在本病例中,胸椎手术后应用 DuraSeal ® 修复了手术区域的硬膜缺损,术后未立即出现神经系统问题。但一天后,患者的偏瘫症状加重,因此再次进行了手术,症状有所改善。
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引用次数: 0
Tarsal Tunnel Syndrome: A Narrative Review 跗骨隧道综合征叙述性综述
Pub Date : 2024-04-22 DOI: 10.21129/nerve.2024.00528
Jahyung Kim, Jaeho Cho
. Several intrinsic or extrinsic factors may contribute to pain over the medial plantar aspect of the foot that is aggravated by activities. In the presence of suggestive clinical features, appropriate use of radiographic and electrodiagnostic tests can be helpful. Surgical management is considered in patients who do not respond to non-operative treatment or those who have a space-occupying lesion within the tarsal tunnel. Along with surgical decompression of the posterior tibial nerve, complete removal of the causative space-occupying lesion is needed to prevent recurrence.
.导致足内侧足底疼痛并因活动而加剧的内在或外在因素可能有多种。在有提示性临床特征的情况下,适当使用放射学和电诊断测试会有所帮助。对于非手术治疗无效或跗骨隧道内有占位性病变的患者,可考虑手术治疗。在对胫后神经进行手术减压的同时,还需要彻底切除致病的占位性病变,以防止复发。
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引用次数: 0
Glioblastoma Presenting with the Radiological Features of a Meningioma: A Case Report and Literature Review 表现为脑膜瘤放射学特征的胶质母细胞瘤:病例报告和文献综述
Pub Date : 2024-04-17 DOI: 10.21129/nerve.2024.00507
Sang-Jeong Song, Jeong-Ho Lee, Myung-Han Ryu, Min-Seok Lee, Sang-Jun Suh, Yoon-Soo Lee, Soo-Ho Cho
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引用次数: 0
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The nerve
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